High School Drinking and Its Consequences
Arata, Catalina M., ord, Jeremy, Tims, M. Scott, Adolescence
Alcohol use continues to be one of the most significant risk behaviors engaged in by teens, as indicated, for example, by results from the 2001 Monitoring the Future survey (Johnston, O'Malley, & Bachman, 2002). In that survey, 63.5% of tenth graders and 73.3% of twelfth graders reported drinking in the past year, with 39.0% and 49.8%, respectively, reporting alcohol use in the past 30 days. Having been drunk in the past 30 days was reported by 21.9% of tenth graders and 32.7% of twelfth graders. An important issue is whether adolescents' use of alcohol is problematic merely because they are underage, or whether adolescents are, in fact, engaging in problem drinking with associated negative consequences. Attitudes toward teenage drinking are often mixed, in fact, because of ambiguity regarding whether this behavior represents a problem beyond that associated with age.
Problems associated with alcohol use have most often been examined in terms of heavy consumption. Problem drinking is typically defined based on high frequency and/or high quantity, with consumption of 5 or more drinks on one occasion (i.e., binge drinking) being a common definition (e.g., Jones-Webb, Toomey, Short, Murray, Wagenaar, & Wolfson, 1997). Research has indicated that problem drinking is common among high school students. In a longitudinal study of adolescent risk behaviors, Oullette, Gerrard, Gibbons, and Reis-Bergan (1999) found that 39.5% of younger adolescents (ages 14 to 16) reported having consumed a whole glass of beer or wine recently. This number doubled to 81.5% for older adolescents (ages 17 and 18). Ouellette et al. also found that 22.1% of younger adolescents and 64.1% of older adolescents reported drinking to excess recently.
Problem drinking among teenagers is, not surprisingly, associated with a number of negative consequences. Ouellette et al. (1999), for example, found that among teenagers who reported drinking, 83.8% said they had experienced at least one alcohol-related problem in the past twelve months. These problems included hangovers, behaving in ways they regretted, getting into arguments because of drinking, and being unable to remember part of the evening. Of even greater concern are alcohol-related motor vehicle accidents among teenagers. Hingson (1993) estimated that 50% of all fatal car crashes among drivers under the age of 21 involve alcohol. Furthermore, Bachman, Johnston, and O'Malley (1987) noted that one in four high school seniors reported driving after drinking in the past two weeks, and two in five seniors reported having ridden with a driver who had been drinking. Additionally, Derman, Cooper, and Agocha (1998) found that alcohol use was associated with greater sexual risk taking. Fergusson and Lynskey (1996) found that adolescents who used alcohol reported an earlier onset of sexual activity.
Various studies have sought to identify variables associated with problem drinking and its consequences. Research on predictors of negative consequences has primarily focused on peer influences, parental influences, and alcohol consumption rates. In a longitudinal survey of rural adolescents, Oullette et al. (1999) examined the roles of alcohol consumption, perceived norms, and parental alcohol consumption on alcohol expectancy, future consumption, and related life problems. Data were compared across time periods: Fall 1992 (Time 1) to Spring 1994 (Time 4). They found that perceptions regarding peer alcohol use were directly related to alcohol consumption across time and to alcohol-related life problems at Time 4. Alcohol consumption at Time I and parental consumption at Time 1 were not directly related to negative consequences of alcohol use at Time 4, though they did have indirect relationships through beliefs about alcohol. Alcohol consumption at Time 4 was predicted by perceived norms at Time 1. In their model, Oullette et al. included expectations regarding alcohol and the kind of people who drink. Their results suggested that parent and peer drinking influence perceptions regarding the effects of alcohol and contribute to rates of alcohol consumption. The more parents drink and the more adolescents perceive their peers to drink, the more the adolescents themselves drink. The results suggested, though, that peer influences are more important than parent influences.
Beck and Treiman (1996) also found that peer variables were of greater significance than parenting variables in predicting negative consequences of alcohol use. They examined various indices of problem drinking (e.g., binge drinking, driving while under the influence of alcohol, riding with an alcohol-impaired driver) and their relationship to social context variables. In contrast to low-intensity drinkers, high-intensity drinkers were more likely to drink to facilitate social interaction and for stress control and school defiance, and they perceived greater peer norms for alcohol use. Beck and Treiman found that peer approval was not as important as perceptions of peer norms regarding drinking. However, they did not find any significant relationships between parenting variables and problem drinking.
Jones-Webb et al. (1997) looked at the influence of perceived peer norms on alcohol consumption, as well as the influence of alcohol availability. They found that higher rates of alcohol consumption among teenagers were associated with greater perceived ease in obtaining alcohol, liberal drinking norms, having peers who got drunk in the past month, and the belief that they would not get caught (by police, parents, or school officials). In addition, for males, being older and not having someone home after school were associated with greater consumption, while for females, drinking in a public location and lower parental education level were associated with greater consumption. Greater consequences associated with drinking were related to higher rates of drinking. In addition, males who reported having a peer who got drunk in the past month were 12 times more likely to report a negative consequence of drinking. Overall, the most negative consequences associated with drinking were reported by males and females who consumed more alcohol, binged at least twice in the past 2 weeks, reported more liberal drinking norms, and had more friends who got drunk. These findings are consistent with the previously discussed research in demonstrating the importance of peer norms regarding drinking, specifically in terms of negative consequences associated with alcohol use.
In an effort to predict adverse consequences of alcohol and other drug use, Thomas (1997) developed a path model based on data from a sample of college students. Thomas found that personality variables and cognitive motivation for drinking contributed to harmful effects, above the risk resulting from actual consumption. Consistent with Oullette et al.'s (1999) findings, cognitive motivation, or beliefs about alcohol, was one of the most important variables, having direct and indirect effects for substance use and harmful effects. Thus, beliefs about the effects of alcohol contribute to alcohol use and to harmful effects.
Barnes, Farrell, and Dintcheff (1997) also examined the roles of family and peer variables in predicting alcohol abuse and related problems. Outcome variables included frequent heavy drinking, deviant behavior (e.g., skipping school, staying out past curfew, having sex, beating up someone), and psychological distress. Parental drinking was not associated with adolescent heavy drinking; however, higher levels of maternal support and parental monitoring predicted lower levels of heavy drinking and deviance. At the same time, friend's drinking was a strong predictor of adolescent drinking, while friend's deviance was a strong predictor of adolescent deviance. In a separate analysis of the same sample, Barnes, Farrell and Banerjee (1987) reported a high correlation (.40) between heavy drinking and deviance. While parental drinking was not related to adolescent drinking or problems, Barnes, Welte, and Dintcheff (1992) found that among college students, males who had a father who drank heavily were at greater risk for having alcohol-related problems and were heavier drinkers.
The purpose of the present study was threefold: (1) to examine the prevalence of problem drinking among adolescents at an urban, private high school; (2) to identify frequencies of problems related to drinking; and (3) to identify parent and peer variables associated with being a problem drinker. Rather than merely defining problem drinking in terms of amount of alcohol consumed, this study examined the relationship between heavy drinking and engaging in other problematic behaviors. Further, the study examined the relationship between parent and peer variables and negative consequences associated with alcohol use.
Nine hundred thirty adolescents at an urban, private high school participated in an anonymous survey regarding alcohol use and related factors. Participants ranged in age from 13 to 19 years, with an average age of 15.65 (SD = 1.13). The sample was fairly evenly divided between males (52%) and females (48%). Students in all grades were surveyed, with the final sample consisting of 189 (20.4%) freshmen, 273 (29.4%) sophomores, 261 (28.2%) juniors, and 204 (22.0%) seniors.
Demographic data. The questionnaire gathered information regarding sex, age, current year in school, and current living situation (e.g., both parents, mother and stepfather).
Alcohol use. Three questions were used to assess use of alcohol. Participants were asked to indicate how often, during the last school year, they drank alcoholic beverages; when they drank alcohol, how much did they usually drink; and what was the most they ever drank at one time. Responses were categorical: 0 drinks, 1-2 drinks, 3-4 drinks, 5-6 drinks, 7-8 drinks, and more than 8 drinks. These questions were considered individually in the bivariate analyses and were summed to produce a total alcohol consumption score for the multivariate analysis. The total alcohol use score based on these three questions had a coefficient alpha of .90. Problem drinking was defined as typically drinking five or more drinks at one time. Respondents who reported typical consumption of one to four drinks were categorized as moderate drinkers.
Alcohol-related problems. Participants completed the Rutgers Alcohol Problem Index (RAPI; White & Labouvie, 1989). The RAPI is a 25-item self-report measure of negative effects of alcohol use. Respondents indicated how many times, during the last school year, they had a specific problem related to their use of alcohol. The RAPI assesses effects on school and social functioning, as well as the use of alcohol while driving and increases in aggression associated with drinking. White and Labouvie report high reliability (.92) and that scores on the RAPI had only moderate correlations with alcohol-use intensity, indicating that this measure assesses a different aspect of problem drinking.
The same items used by Dielman, Butchart, and Shope (1993) to assess the role of parent variables in influencing adolescent drinking were administered in the present study.
Parental use of alcohol. Four questions were included regarding parental use of alcohol. Participants were asked to indicate how often each parent (mother and father separately) drinks alcohol (never, once or twice a year, three or four times a year, once or twice a month, once or twice a week, daily) and how much each usually drinks (none, 1-2 drinks, 3-4 drinks, 5 or more drinks). Scores on these items were summed. The scale had a coefficient alpha of .65.
Parental approval of alcohol use. Four questions assessed parental approval of teenage drinking, specifically whether parents allowed drinking when they were or were not present, and participants' perceptions of their parents' attitudes toward teenagers drinking or getting drunk. This scale had a coefficient alpha of .74 for the current sample.
Parental permissiveness. Four questions regarding parents' responses to misbehavior and use of money were used to assess parental permissiveness. These items were rated on a 4-point Likert scale (never, sometimes, usually, always). This scale had a coefficient alpha of .59 for the current sample.
Parental monitoring. Six questions assessed parental monitoring, such as whether parents keep track of their children's whereabouts and whether parents notice and respond to good and bad behavior. These items were rated on a 4-point Likert scale (never, sometimes, usually, always). This scale had a coefficient alpha of .63 for the current sample.
Susceptibility to peer pressure. Seven items were included regarding susceptibility to peer pressure. These items assessed participants' tendency to go along with peers on a variety of behaviors (e.g., drinking, smoking). These items were rated on a 4-point Likert scale (never, sometimes, usually, always). This scale had a coefficient alpha of .80 for the current study.
Peer norms. Perception of peer drinking was assessed with a single question. Participants indicated how often they believed their peers drank alcohol (never, sometimes, often, usually, always).
Letters were sent to all parents, several weeks prior to the study, informing them of the nature of the research and providing them with the option of having their children not participate. Questionnaires were administered in a course that all students are required to take. The questionnaires were administered on the same school day, throughout the day, by graduate and undergraduate psychology students. Participants were informed that at no time would faculty, staff, or administrators at the school have access to individual questionnaires. Because this was to be a two-part study, it was necessary to use subject numbers and have some method of connecting subject numbers to names for the second phase. For this purpose, students were given an envelope that had two labels with their subject number. They were instructed to put one of the labels on their questionnaire, seal the envelope, and write their name on the outside of the envelope. They were informed that the envelopes would remain sealed and be kept by the researchers until the research team returned in the spring. At that time, they would open their own envelope to obtain their subject number for the second phase of the study.
Rates of Alcohol Use
Rates of alcohol use were consistent with national surveys on teenage drinking. Seventy-five percent of the students reported having consumed alcohol in the past school year, with 30% reporting frequent problem (binge) drinking (5 or more drinks). Sex and year in school were significantly related to all measures of alcohol use, with students in higher grades and males reporting greater use of alcohol. Sex and year in school were also significantly related to being a problem drinker. One hundred sixteen (24%) males and 124 (28%) females reported no use of alcohol; 165 (34%) males and 232 (53%) females reported moderate drinking; and 198 (41%) males and 82 (19%) females reported problem drinking.
Factors Related to Problem Drinking
Analysis of covariance was used to examine the relationship between peer and parent variables and problem drinking. Year in school was entered as a covariate and sex was included as a factor. Problem drinking was associated with significantly higher scores on all measures: parental use of alcohol, parental permissiveness, parental approval of alcohol use, parental monitoring, susceptibility to peer pressure, and peer norms (Table 1). Sex was significantly related to parental permissiveness, with females reporting greater permissiveness than males. There was also a significant interaction between parental monitoring and sex. Nondrinkers reported the highest level of parental monitoring. Male and female moderate drinkers and male problem drinkers reported less monitoring than nondrinkers, while female problem drinkers reported the lowest level of monitoring.
On all measures except parental use of alcohol and parental monitoring, all three groups (nondrinkers, moderate drinkers, and problem drinkers) were significantly different from each other. Moderate and problem drinkers reported significantly higher rates of parental use of alcohol but did not differ significantly from each other. Likewise, moderate and problem drinkers reported less parental monitoring than nondrinkers but were not significantly different from each other.
Problems Associated with Alcohol Use
Analysis of variance was also used to examine differences in scores on the RAPI (Table 1). Problem drinkers reported significantly more negative behaviors associated with their drinking than did moderate drinkers or nondrinkers, and moderate drinkers reported significantly more problems than nondrinkers. Responses to the individual items were examined to identify the types of problems being reported. The most frequent problem was neglecting responsibilities due to drinking, which was noted by 41% of the sample. Other common problems were: getting into fights, acting bad, or doing mean things (33%); causing shame or embarrassment to someone (36%); having a fight, argument, or bad feelings with a friend (32%); and having a bad time (31%). The most infrequent problems were: having withdrawal symptoms (9%) and feeling that you had a problem with alcohol (7%). Other notable problems included missing school or work (15%), finding yourself in a place that you could not remember getting to (27%), passing out (23%), driving after 2 drinks (20%), driving after 4 drinks (14%), and engaging in sexual behavior you would not have engaged in otherwise (23%). Twenty-eight percent of the students reported feeling they needed more alcohol than usual to get the same effect.
Hierarchical regression was used to identify the variables that contributed most to the prediction of problems associated with drinking. The total score on the RAPI was the dependent variable, and demographic variables (year in school, sex), parent variables (use of alcohol, approval of alcohol use, permissiveness, monitoring), and peer variables (peer norms, susceptibility to peer pressure) were entered as independent variables.
The final model (Table 2) included susceptibility to peer pressure, peer norms, parental alcohol use, parental monitoring, parental approval of alcohol use, year in school, and sex. These variables accounted for 31% of the variance in RAPI scores, F(8, 904) = 51.7, p < .0001. Parental permissiveness was the only variable that did not remain significant when peer variables were added to the model.
The purpose of the present study was to determine the extent of problem (binge) drinking at an urban, private high school and to identify factors related to problem drinking, including the types of problems associated with heavy alcohol use. While the rates of drinking were comparable to those reported in other research, binge drinking was alarmingly common. Thirty percent of the students reported that the usual amount of alcohol they consumed was 5 or more drinks at a time. Sex and year in school were related to alcohol use, with males and students in higher grades reporting more use on all indices, including problem drinking. Interestingly, females were significantly more likely to be moderate drinkers than were males. Rates of nondrinking were comparable for males and females. Thus, female adolescents who drink are more likely to be moderate drinkers (less than 5 drinks on average), whereas male teenagers who drink are more likely to drink in excess (more than 5 drinks on average). While physical size could make these differences less meaningful, even when size has been considered in other research, males typically report greater consumption of alcohol. Despite this difference in amount of alcohol consumed, sex had little relationship to factors associated with problem drinking, and males were no more likely to report negative consequences associated with alcohol use than were females.
Interestingly, all the variables studied were associated with problem drinking. Problem drinkers were more likely to have parents who approved of teenagers drinking, as well as had more permissive parents, than moderate drinkers and nondrinkers. Problem and moderate drinkers reported greater parental consumption of alcohol and less parental monitoring. These results clearly suggest that parental role modeling and supervision are factors in the decision to drink and in the extent of drinking that is engaged in by teenagers.
Peer variables were also associated with levels of drinking. Problem drinkers were more susceptible to peer pressure than were nondrinkers and moderato drinkers. In addition, problem drinkers described their peers as drinking more in comparison with nondrinkers and moderate drinkers. This is consistent with the notion of "birds of a feather flock together." That is, heavy drinkers may be more likely to socialize with other heavy drinkers, with nondrinkers associating with nondrinkers. At the same time, this factor could interact with susceptibility to peer pressure to influence behavior. If conformity is important to you, and your peer group does not drink, perhaps you will also not drink. Likewise, high need for conformity combined with a more deviant peer group could lead to an increase in deviant behavior. Disapproval by peers as a factor in drinking, however, is not likely to deter many students. The Monitoring the Future survey (Johnston et al., 2002) found that only 34.7% of tenth graders disapprove of trying one or two drinks, with 69.2% disapproving of drinking five or more drinks once or twice each weekend. While this suggests that the majority of tenth graders disapprove of frequent binge drinking, approximately one out of three tenth graders do not disapprove of frequent binge drinking.
The students reported a broad range of problems associated with their drinking. The most common problems included neglecting responsibilities, having a bad time, and acting in a negative way, such as getting into arguments or fights and embarrassing others in some way. Serious consequences associated with drinking were reported by a sizable number of students, with one-fourth reporting blackouts or passing out. Further, nearly one-fourth of the students reported engaging in sexual behavior they would not have engaged in otherwise. One-fifth reported driving shortly after having 2 drinks, and 14% reported driving after 4 drinks. Over one-fourth reported signs of increased tolerance (felt they needed more alcohol than usual to achieve the desired effect). Despite the high frequency of problems associated with drinking and the high rate of binge drinking reported, only 7% of the students felt they had a problem with alcohol.
The results of this study highlight the fact that alcohol use is a serious problem among high school students. A sizable number of students reported frequent binge drinking as well as numerous negative consequences associated with their drinking. Nevertheless, the vast majority did not consider their drinking to be a problem.
This study identified parent and peer variables that are associated with teen drinking. Parental role modeling and supervision were found to be related to amount of alcohol consumed, as were susceptibility to peer pressure and perception of peer drinking behavior.
There are a number of limitations to these findings. Most importantly, participants were students at a private school, and most likely not representative of other samples of teenagers. However, this parochial high school did have a broad range of Students. Given that a private school education may be chosen in the hope of reducing the risk of alcohol and drug use, these results serve notice to parents that teens in private schools may be drinking as much as teens in other national samples.
A further limitation of this study was the reliance on self-report, which could have affected the accuracy of the data on drinking and associated problems. Again, the consistency in rates of alcohol use compared to national samples suggests that these results are as valid as those obtained in similar research.
Prior research has suggested that expectations regarding the effects of alcohol are strong predictors of alcohol use (Ouellette et al., 1999). Given that many adolescents have positive expectations regarding the effects of alcohol (due to parent and peer behaviors), the present study could serve as a source of reality education. The findings suggest that, contrary to adolescents' expectations, there are actually many negative effects of alcohol use, including, most simply, having a bad time. Further research is needed to identify variables that differentiate problem drinkers from nonproblem drinkers and to develop effective interventions for reducing adolescent drinking and its consequences.
Table 1 Mean Scores on Parent Variables, Peer Variables, and Rutgers Alcohol Problem Index Nondrinker Moderate Drinker Male Female Male Female (n = 116) (n = 124) (n = 165) (n = 232) Parental use 6.27 6.41 7.20 7.17 of alcohol Parental approval 2.42 2.31 3.04 3.07 of alcohol use Parental 5.59 5.58 6.20 6.79 permissiveness Parental 12.05 12.93 11.28 11.70 monitoring Susceptibility to 3.90 3.40 8.33 8.08 peer pressure Peer 1.01 1.19 1.77 1.95 norms RAPI 1.65 .83 7.04 7.12 Problem Drinker F Values Male Female (n = 198) (n = 82) Model Sex Parental use 7.50 8.15 4.49 * 1.10 of alcohol Parental approval 3.61 3.56 23.09 * .22 of alcohol use Parental 6.71 7.48 16.58 * 10.66 * permissiveness Parental 11.70 10.78 7.35 * .39 monitoring Susceptibility to 10.92 11.80 109.71 * .03 peer pressure Peer 2.84 2.67 81.52 * .86 norms RAPI 18.30 18.59 72.16 * .04 F Values Problem Inter- Drinker action Parental use 11.18 * .71 of alcohol Parental approval 51.77 * .26 of alcohol use Parental 36.01 * 2.73 permissiveness Parental 13.33 * 6.51 * monitoring Susceptibility to 262.33 * 2.43 peer pressure Peer 174.32 * 2.72 norms RAPI 161.25 * .19 * p < .05 Table 2 Multiple Regression: Demographic, Parent, and Peer Predictors of RAPI scores Model Variable Beta t p [R.sup.2] Step 1 .04 * Sex -.126 -3.89 .000 Year in school .155 4.78 .000 Step 2 .15 ** Sex -.122 -3.96 .000 Year in school .110 3.52 .000 Parental alcohol use .139 4.36 .000 Parental approval .120 3.46 .001 Parental permissiveness .120 3.62 .000 Parental monitoring -.167 -5.36 .000 Step 3 .31 *** Sex -.079 -2.83 .005 Year in school .074 2.50 .013 Parental alcohol use .097 3.36 .001 Parental approval .227 7.00 .000 Parental permissiveness .011 0.34 .732 Parental monitoring -.101 -3.54 .000 Susceptibility to peer pressure .373 10.94 .000 Peer norms for alcohol .123 3.66 .000 * F(2, 910) = 18.8, p < .0001. ** F(6, 906) = 26.9, p < .0001. *** F(8, 904) = 51.7, p < .0001
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Catalina M. Arata, Jeremy Stafford, and M. Scott Tims, Department of Psychology, University of South Alabama. Jeremy Stafford is now with the Behavioral Research Center of the American Cancer Society. M. Scott Tims is now at Idaho State University.
Requests for reprints should be sent to Catalina M. Arata, One Office Park, Suite 305, 273 Azalea Road, Mobile, Alabama 36609. E-mail: vkarata@bell south.net…
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Publication information: Article title: High School Drinking and Its Consequences. Contributors: Arata, Catalina M. - Author, ord, Jeremy - Author, Tims, M. Scott - Author. Journal title: Adolescence. Volume: 38. Issue: 151 Publication date: Fall 2003. Page number: 567+. © 1999 Libra Publishers, Inc. COPYRIGHT 2003 Gale Group.
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